Two articles have been published in the medical literature that show a medication we have used for Tourette’s syndrome in the past may prove useful for managing patients with ADHD. The articles indicate that those patients studied improved significantly when compared to a placebo in both hyperactivity and inattention.
It appeared that 50 percent of the patients had a beneficial response. This may not be as great as we see with current stimulant medications. But for those patients who cannot tolerate stimulants this may provide an effective mode of therapy.
The medication has been named INTUNIV and is an extended release form of a short acting form, TENEX (the chemical name is GUANFACINE).
The duration of action of INTUNIV is 8-to-12 hours, depending on the dose. An EKG should be done prior to starting the medication to assess the QTc interval, as in some cases it may prolong this time interval with negative effects. It has been found that a QTc less than .440 indicates it is safe to prescribe this medication.
This medication may prove ideal for patients who have combined Tourette’s syndrome and ADHD. One article indicates that ADD patients as opposed to ADHD patients may respond in lower numbers.
This may prove to be a really significant addition to our ADHD arsenal. Currently methylphenidates (Ritalin, Concerta, Focalin, Daytrana) and amphetamines (Adderall, Vyvanse) remain our first line drugs. Strattera, Wellbutrin and Provigil have proven to be necessary for selected patients. I hope INTUNIV (Guanfacine extended release) will prove as effective in our patients as in the articles sighted. Time will tell, but hope springs eternal.
1. PEDIATRICS, 2008; 121; e 73 - e 84
2. JOURNAL OF AMERICAN ACADEMY of CHILD and ADOLESCENT PSYCHIATRY, 48: 2, February 2009